january 19. 2001 » ju st o*rt, 7
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Hepatitis C crisis hides in the shadows
of HIV spotlight by N atalie Shapii
)iro
n 1992, a deadly new virus was discov
ered, one that soon would surpass AIDS
in infection rates. By the end of the
decade, three times as many people would
he infected with hepatitis C as with HIV.
Despite the voracity of this virus, there is only a
fraction of the funding for hepatitis C programs
as for AIDS programs and, until recently, only a
fraction of the concern.
The hepatitis C virus can linger for years in
an unsuspecting host’s body. Some might expe
rience mild flulike symptoms in the initial
acute phase of infection. Most move on to the
chronic phase, which can take decades and
might lead to complications such as cirrhosis or
liver cancer.
According to Dr. Ann Thomas, Oregon
Health Division medical epidemiologist, 10 per
cent to 20 percent of those with hepatitis C get
cirrhosis and 1 percent to 5 percent die. Unlike
hepatitis A or B, there is no vaccine for the
hepatitis C virus.
Another complication is AIDS/hepatitis C
co-infection. The U.S. Public Health Service
estimates one-third of those with AIDS also are
infected with hepatitis C.
Such individuals have fewer treatment
options: Many HIV drugs cause serious dam
age to the liver of those with hepatitis C.
Those with both diseases are seven times as
likely to die of liver failure than those with
only hepatitis C.
The hepatitis C virus is spread via blood.
The major means of transmission is through
intravenous drug use; half of those with the virus
contracted it that way. Prior to the enforcement
of screening procedures around 1993, blood
transfusioas were another common method of
transmission.
Public health institutions stress that there
are other ways to acquire the disease. Dr. C.
Everett Koop, former U.S. surgeon general,
states that using straws to snort drugs presents an
abnormally high risk of contracting hepatitis C.
The disease also can he transmitted sexually and
from household contact, such as sharing razors
or toothbrushes.
Exactly how many people have the disease is
unclear. Koop thinks hepatitis C already infects
three times more people than does AIDS.
He states in his Web site that recent studies
suggest 4 5 million people in the United States
have the virus. Many in the public health serv
ices agree it is an epidemic. Hepatitis C is more
easily transmittable partly because it is resistant
to bleach, heat and time— unlike the more frag
ile HIV.
Multnomah County only has maintained a
voluntary record-keeping system of those who
tested positive for the virus since May 2000. So
far, it is finding about 200 new cases a month.
Gary Oxman, Multnomah County health
officer, said he doesn’t know whether those
numbers are high. “It’s going to be years before
we see how much is out there.” Based on the
national average of infected people, he estimates
10,000 to 12,000 Multnomah County residents
are infected with hepatitis C.
Despite the high incidence rates of
hepatitis C, there is a dearth of information and
assistance. “It’s a junkie disease,” explained
Phyllis Beck of the Hepatitis C Awareness Proj
ect, based in Eugene. Her words are reminiscent
of the early days of the AIDS crisis, when apa
thy and homophobia prevented prompt action
to address the crisis.
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Beck is frustrated
sociation Project for
with the lack of momen
organizing on behalf of
tum in the public health
ultnomah County recommends hepatitis C sufferers,
community in helping
hepatitis C testing for anybody who: The project, which
those with hepatitis C.
Ever injected or snorted drugs.
works with those in
It is especially tough for
Had unprotected sex with multiple recovery from drug use
partners.
and alcoholism, helped
those in the prison sys
tem. She said of the 6
Had unprotected sex with someone organize a hepatitis C
million people incarcer
infected with hepatitis C.
program for Multnom-
ated, almost 40 percent
Had a hlcxxl transfusion before 1992. ah County.
Was treated for hlcxxl clotting prob
In July 1999, the
are infected with hep
Hepatitis C Task
lems before 1987.
atitis C.
And she finds they
Had a birth mother infected with the Force was formed.
The county now is
hepatitis C virus.
receive little or no care
in the Oregon prison
Has been a longtime kidney dialysis implementing hepati
tis C education into
system. “We are seeing
patient.
its street outreach
more and more inmates
who are being released with cirrhosis or close to program, into its needle exchange program
cirrhosis due to lack of follow-up care after a and in correctional facilities.
Ronnie Meyers, Multnomah HIV Preven
positive diagnosis has been made.”
Beck and others also find resistance to med tion Program health services specialist, said her
ical care and information from doctors. “We are agency also plans to educate health care
given wrong information from doctors, especial providers about hepatitis C. For those with the
ly if we are on the Oregon Health Plan,” she disease, the county will help find them a health
asserts. “Patients get liver biopsies, see how had care provider. “If they are uninsured, we try to
it is and want therapy. But the doctors don’t hook them up with a provider.”
However, one element affecting hepatitis C
want to be bothered with it.”
Kim Matic, Recovery Association Project care and prevention is that no free testing facil
assistant director, became frustrated with the ities exist. Multnomah and Washington coun
inconsistent information from doctors. “I started ties lack such programs even though people
asking questions,” she said pointedly. “We found request free testing.
However, both counties have free HIV
we couldn’t get information from the medical
screening programs. Again, the issue is lack of
community.”
Part of the problem is a lack of knowledge funding. “There is more funding for HIV than
about the virus; funding and apathy are also to for hepatitis C ,” Meyers explained.
Nonprofit social service groups also have
blame. “It’s recent knowledge and interest,"
Oxman explained. “IV drug users are not the folded hepatitis C into their programs. Both
Outside In and Yellow Brick Road incorporate
most popular group in the community.”
Limited studies have been conducted on the hepatitis C education into their street youth
disease, partly because of funding. Thomas programs.
Jessica Guernsey, Yellow Brick Road out
noted the Centers for Disease Control “funds a
fraction of studies for hepatitis C than for HIV.” reach coordinator, said things are getting better.
Oxman credits groups like the Recovery As- “But it’s unfortunate—seeing the numbers—
that it took so long to get action."
Cascade AIDS Project d<x;sn’t have a spe
S upport G roups for
cific hepatitis C program hut welcomes those
T hose with H epatitis C
with the disease. “It’s just now catching on in
• Multnomah County Health Department: public health; people know it’s a big, big prob
lem," admitted Doug Zeh, CA P advocacy case
503-988-3816.
• Recovery Association Project (Central worker. “As the numbers are believed to he
larger than with HIV, the cost of treating it is
City Concern): 503-294-1681.
• Hepatitis C Awareness Project: P.O. Box very, very high; no one comes to grip yet on
41803; Eugene, OR 97404-0520; hepcaware® how to do that.’
aol.com.
NATALIE S hapiro is a free-lance tenter who
• Hepatitis Hotline: 888-443-7232.
M
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